## Transmitta l o f Omah aLea dSite Pain t Stabilizatio n Fil e Folde r Said # ^O^b H Date : S-'/'^-J^c S Address : /I7 3 li/7//ra.t i & ^ 

### Conti-actor : Cit

y o f Omah aYear : J^Qi J d 

## Pain t Stabilizatio n Propert y Fil e Folde r

Document s 6^Wor k Writ e U p __i^Signe dAcces s Agreemen t fo r subject propert y Pre-Renovation for

msignedb

y Propert y Owne r Pre-Renovation For

mfo r Occupant/Tenant , ifapplicabl e y Painting Agreement/Cit y o f Omah aPurchas e Orde

r Settlemen t documents (i.e. , fo

r damage o r t o replac e plants , etc. ) Renovation Recordkeepin

g Checklis t

signe db y Certifie dRenovato

r ^^Propert y informatio

n fromDougla s Count

y Assessoi*' s Offic

e Othe r (describe) : r/lo/^ 3 1

/ f5>v vH>\ ^ 

### /^^-^L- - 3-yr^/ ^ Cit y of Omah aRepresentative Signatur

e Dat e

' A RpnrPBPntafiv p .^ionntiir e ' Datf t 

### EP A Representativ e Signature. . . ' Dat e 3026243 1 Superfun dPlannin g Departmen t Inspector : Jame s Janovic h Omaha/Dougla s Civi c Cente r S 1 Q 9nn 8 ^^^ ' Farna mStreet , Suit

e 100 3 J-i:/-ZUU O Omaha . Nebrask a6818 3 (402 ) 444-515 0 

## Loui s Cortez an

dTeieft.x(402 ) 545-071 4 T- v 1 /^i l 1

- J Steve n N . Jensen , AIC P Cit y o f Omah aDaTlCn e LnaDOUa e Director Mik e F.hey . Mayo r

111 3 Willia mS t 

## OMAHA EXTERIO RPAIN T STABILIZATIO N PROGRA M

FO RTH E EP A OMAH

A LEA D SIT E The Contract

bi ddocument s consis t

o f the following sections : • General Responsibilitie s for th e Contracto r

and.Occupant . • Lea dHazar dContro l Plan , Interi mContro l of Lea dBase dPain t

Hazards . Th e Contracto r

Shall : • Compl y wit

h HUD' s "Guideline s for

di e Evaluatio n an dContro l of Lead-Base d Pain t Hazard s in Housing. " (Copie s ar e availabl e a t th e Plannin g Department. ) • Compl y wit

h Standard s calle dfor

in th e "Constructio n An dRehabilitatio n Specifications , Housin g an dComiriunit y Developmen t

Diyision,,..Cit

y o f Omaha , Nebraska. " (Copie s ar e availabl e a t th e Plannin g Department.).. ; • • Compl y wit

h th e Stat e o f

Nebrask aHealt

h an dHuma

n Service s Regulatio n an d Licensure , Titl e 17 8 Chapte r 2 3 Lea dBas e Pain t

Regulations . ..- ^ , • Coordinat e dail y constructio n schedul e wit h th e occupan t • Submi t

informatio n cu t

sheet s for

al l substitution s o r

approve dequal s prio r

t o writte n approva l o f

th e Rehabilitatio n Inspector . • Repai r

o r replac e al l item s damage do r disturbe ddurin g construction . • At all times kee p th e sit e of

wor k an dsurroundin g are afre e fro maccumulation s o f wast e material s o r

rubbis h cause db y th e work . • Upo n dail y completio n of wor k clean u p all rubbish , exces s material , equipment ^ an detc. , that

i s connecte dwit

h th e work , an dleav e all part s of th e wor k area s i n a neat , sanitary , lea dsaf

e an dpresentabl e condition . • Complet e thi s projec t

withi n 3 0 calenda

r days . Th e Occupan t

Shal l • Remov e an dstor e away an y personal property withi n twent y (20 ) feet

o f th e are a t o b e remediated . • Remov e voluntee r

tree s an dvegetatio n fromth e dri p lin e of th e roof , an dcu t bac k shrub s an dbushe s a

t leas t tw o feet fromth e hous e an dgarage . • Ensur e tha t

al l househol dmember s stay a t leas t te n feet awa y fro mall wor k area s an dals o kee p al l pet s a

t leas t te n feet awa y a t al l time s unti l th e wor

k ha s bee n complete dan dth e are aha s passe davisual inspection . j Initial s r

• ^111 3 Willia mS t (continued ) 

## Lea dHazar dContro l Pla n Interi mContro l o

f Lea dbasedPain

t Hazard s Pain t Stabilizatio n • Prepar e an dpain t

al l previousl y painte dexterio r surface s of

th e dwellin g t o includ e th e fascia , eaves , siding , trim , windo w trim , doo r tri man d foundation . D o no t

pain t window s o r

doors . • Prepar e an dpain t

all previousl y painte dsurface s o f th e fron t porch . • Prepar e an dpain t

all previousl y painte dsurface s o f th e decks . • D O NO T PAIN T VEsfYL, STEEL , O RALUMINU M SURFACES . • Al l pain t

color s t o matc h existing . Prim e an dappl y tw o coats . • Se e plannin g Department' s lis t of approve dpain t

product s fo

r lead projects . 

### Lea dBasedPaint

Wast e Lead-base dpain t

waste mus t

b e handle da s follow s Al l pain t chip s an dcomponen t

debri s mus t

b e doubl e bagge dfor

disposal . Clean pain t

chip s before starting , durin g an dafte r th e project . Al l lea dpainte dcomponent s an ddebri s mus t b e remove dfro

mth e sit e dail y unles s otherwis e approve db y th e constructio n specialist . Al l lead-base dpain t

debri s (chip s an dcomponents ) mus t b e dispose do

f in amunicipa l soli dwaste landfill . Property Owne r PropertyOwne r 

# n _&li2 k

Witnes s .<VL . 

# ( t

Occupan t (i f applicable ) Dat e Occupan t (i f applicable ) Dat e Witnes s Dat e

## Exterior

Lead-base dPaint

Stabilizatio n Progra

mManagedb

y the Cit y o f Omahafo r EP A Region 7 OmahaLea

dSit e

Th e purpos e of

thi s programi s t o preven t yard s wher e lead-contaminate dsoi l i s cleane d up fro mbecotnin g recontaminate db y deterioratin g exterio r lead-base dpaint . Thi s i s no t ahom e repai r

program . Whic h Home s Are Eligible ? • Home s wher e soi l ciean-u p ha s been or.wil l b e don e an da n EP A contracto r

ha s identifie ddeterioratin g exterio r lead-base dpaint . • Home s are eligibl e onl y b y referral fromth e EPA . What wor k wil l b e done ? • Loos e an dflakin g lead-base dpain t wil l b e remove dsafel y fro mexterio r walls , trim , an dwindo w frames . • Surface s wil l b e prime dan dpainte dt o matc h existin g pain t colo r a s closel y a s possible . What wil l no t b e done ? • Surface s whic h hav e n o pain t wil l no t b e treate d • Window s wil l no t

b e treate d • Rotte n woo dwil l no t

b e replace d • N o housin g repai r

wil l b e don e Wh o wil l perfor

mth e work ? • EP A contractor s wil l tes t pain t on exterio r

hous e surface s an dgiv e th e result s t o th e City o f

Omah aPain t

Stabilizatio n Program . • Cit y Constructio n Specialist s wil l prepare , awor k pla n an dcontac t

th e property owne r for permissio n t o proceed . • Wor k wil l b e competitivel y bi db y approved , traine dcontractors . ^yhe n wil l th e wor

k b e done ? • Thi s programbega

n i n 200 7 an dwil l continu e fo r several years . • Th e City staf

f wil l prioritiz e home s base do n th e presenc e o f childre n under

ag e si x i f know n an dth e severity of th e problem . Pain t Stabilizatio n i s voluntar y an dwil l b e don e onl y wit h permissio n o

f th e owner . 

# L Initial s '^' ^Consen t fo r Acces s t o Propert y RIGH T O F ENTRY T O PREMISE S Granto r (th e property owner) consent s t o an dauthorize s th e Unite dState s Environmental Protectio n Agenc y (USEPA ) o r

it s authorize drepresentatives , collectivel y th e Grantee , t o ente r an dperfon n certai n environmenta l respons e activitie s upon , th e followin g describe dpremises : Owner' s Name : Owne r Name(s) : Loui s Corte z & Darlen e Chaboud e Davtime Phone : 916-600-064 9

Addresse s of

Propertie s Covere db y thi s Agreement Propert y Addres s 1113WIIXIAMS T ^ City/State/Zi p Cod e Omaha , N e

Granto r understand s tha

t thi s grant

doe s no t limi t EPA' s right

o f acces s unde r

th e Comprehensiv e Environmenta l Respons e an dLiabilit v Ac t (CERCLAI . 4 2 USC . & 9601-9675 . o r an v other law . PURPOS E O F ACCES S Th e purpos e of

. th e respons e actio n i s t o stabiliz e loos e o r flakin g exterio r

lead-base dpaint

on residentia l properties , includin g day-care facilities , wher e remediatio n of lea dcontaminate dsoi l ha s o r wil l tak e place . Samplin g of soi l ma y b e conducted . Thi s consen t shal l allo w Grante e ont o Grantor' s property an dfurther , provide s th e Grante e th e right to perfor man y an dal l environmental respons e action s an dactivitie s i t deem s appropriate . ENVIRONMENTA L RESPONS E ACTION S Th e environmenta l respons e action s t o b e performe do n subjec t propert y ma y includ e th e followin g activities ; 1 . Locatin g equipmen t

and/o r machiner y on subjec t

property i n preparatio n for aridi n th e cours e of th e respons e activities . 2 . Obtainin g sample s fromGrantor' s property .



### ( n 2/12/200 7Address: . 111 3 WILLIA M S T Consen t for Acces s t o Propert

v (Pag e 2 ) 3 . Plannin g andimplementin g th e respons e actio n o n th e Grantor' s property . Thi s wil l includ e 1 ) remova l of

loos e o r flakin g pain t

identifie dby EP A usin g lead-saf e method s i n complianc e wit h HUD/EPA regulation s an d2 ) repaintin g accordin g t o th e attache dspecifications . TER M Thi s acces s agreemen t

shal l b e operabl e for

th e perio dof

time i t take s t o complet e th e environmenta l respons e activities . Upo n completio n of the-respons e actions , all rights an d privilege s given b y th e Granto r shal l ceas e o n tha

t date , unles s extende db y asubsequent agreement . AGREEMEN T NO T T O INTERFER E Granto r agree s no t

to interfere wit

h an y o f th e activitie s undertake n b y Grante e a t th e Property , tampe r wit h an y o f Grantee' s property , o r

tak e an y action s regardin g th e us e of th e Propert

y whic h wil l endange r

huma n healt h o r welfare o r

th e environment , o r

allo w other s t o us e th e Propert y i n suc h manne r

durin g th e ter

mof thi s consent . Granto r

agree s to provid e notic e an dacop y of thi s agreemen t t o prospectiv e purchasers , lessees , assigns , o r grantee s o f

th e propert

y o r an y portio n o

f it . Granto r

agree s t o provid e 30-da

y notic e t o EP A prio r

t o an y transfer o f ownershi p right s t o th e property . SAMPLIN G RESULT S Grante e agree s to provid e Granto r wit h th e result s of

any an dal l samplin g and/o r analysi s resultin g fro mGrantee' s respons e activitie s o n th e property . PRIO RCONDITION S AGREEMENT Th e granto r

agree s to th e conditio n of th e property prio r

t o remediatio n an dindicate s on Pag e 3 an y item s t o b e reriioved b y th e Granto r before activitie s corrimencc . RESTORATIO N O F PROPERT Y Excep t for th e abov e state dpain t

stabilization , th e Grante e agree s tha t sai dpropert

y wil l b e restore d a s nearl y a s possibl e t o it s original stat e an dconditio n a s foun dimmediatel y precedin g th e beginnin g o f

activitie s authorize dby thi s Agreement , followin g completio n of th e respons e activities .

(2 \2/12/200 7Address : 111 3 WILLIA M ST , Omaha , Ne , CURREN T CONDITIO N /PROPOSE D RESPONS E ACTIVITIE S Th e purpos e of

thi s sectio n i s t o provid e amutual agreemen t a s t o condition s o f

propert y prior t o contracto r activities . Thi s wil l als o serv e a s documentatio n for th e purpos e of

assurin g tha

t restoratio n activitite s ar

e complete dt o th e satisfactio n of th e propert

y owne r an dth e Unite dState s Environmenta l Protectio n Agenc y (EPA) . Item s t o b e remove db v propertv owne r prio r to th e respons e activities : L . 2 : • . 3 . 4 . 5

- , . Item s NO T t o b e remove db v contracto r durin g removal activities : 1 . 2 . 3 . . 4 . . • • • _ 5 . ADDITIONAL COMMENTS :

I hav e readth e foregoin g documen t an dunderstan dtha

t i t i s a n agreement

grantin g permissio n t o th e Grante e t o ente r

th e abov e -describe dpremise s for th e purpos e of

conductin g environmental respons e activities , an dI agree/ o it s termsan dconditions . 

### Grantor' s Signature : cJ^^Jlt^^puJ^SlztsT^^ . ^^^^J-bQlA-^d ^

(Z \2j\2n.(x nDougla s Count y Accoun t

Informatio n Pag e 1 of 3 Dougla s County , Nebrask a Propert y Recor d - R151970000 2 Informatio n i s vali d a s o

f 2008-4-1 7 Prin t Repor t Parce l Dimenaibn s availabl e O scal e 0-5 0 H wes t o l 14 4 S t - Vie w O n Ma p Treasurer' s Ta x Repor

t Ne w Featur e -»-*- > Aut o Sale s Searct i Owne r CORTE Z LOUI S M hIA L 771 1 DUTRA BEN D D R SACRAMENT O C

A 95831-000 0 Propert y Informatio n Ke y Number : Accoun t Type : Parce l Number : Parce l Address : Lega l Description : 197 0 000 2 1 5

Multipl e Re s 151970000 2 111 3 WILLIA M S T OMAH A N E 68108-000 0 KOUNTZ E 3R D AD D LO T 2 BLOC K1 1 W 4 8 F T LOT 1 & E 1 6 F

T 6 4 X 15 0 Valu e Informatio n 200 7 200 6 200 5 200 4 200 3 200 2 Lan d $5,800.0 0 $5,800.0 0 $5,800.0 0 $5,800.0 0 $5,800.0 0 $0.0 0 Improvemen t $22,600.0 0 • $22,600.0 0 $22,600.0 0 $22,600.0 0 $22,600.0 0 $0.0 0 Tota l $28,400.0 0 $28,400.0 0 $28,400.0 0 $28,400.0 0 $28,400.0 0 $0.0 0 Sale s Informatio n

Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : 2007-05-2 4

W D Book : 200 7 Page : 06243 7 $89,000.0 0 BETHE A HORAC E ETA L CORTE Z LOUI S ETA L Vali d 2000-02-1 4 D Book : 214 4 Page : 50 1 $39,000,0 0

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Informatio n Pag e 2 o f 3

Grantee : Valid/Invalid : Vali d Exclusio n Reason : Sale s Date : 1993-04-2 9 Dee d Type : Book : 195 4 Page : 40 8 Price : $25,000.0 0 Grantor : Grantee : Valid/lnvalid : Vali d Exclusio n Reason : Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.2 2 9600. 0 1. 0 150. 0 64. 0 N o Improvemen t Informatio n Buildin g 1

CLIC KT O ENLARG E IMAG E 

### 111 3 Willia m

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CLIC KT O ENLARGEJMAG. E Squar e Footage : 2214. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Averag e Uni t Type : En d Condition : Fai r Buil t As : 2 1/

2 Stor y Fi n Cond o Squar e Footage : 0. 0 HVAC : Force d Ai r Rooms : 11. 0 Exterior : Fram e Aluminu m Units : 3. 0 interior : Drywal l Baths : 2. 5 Roo f Cover : Compositio n Shingl e Bedrooms : 4, 0 Roo f Type : Gabl e Stories : 2. 5 Floorcover : Allowanc e Foundation : Bloc k

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# >IT Y O F OMAH A PURCHASIN G - ROO M 100 3 181 9 FARNA M STREE T OMAHA , N E 68183-100 3 FAX * 402-444-542 3 

### Purchas e Orde r PURCHAS E ORDE R NO . 114937 2 REVISIO N 1 PAG E

SHI P TO : CIT Y O F OMAH A HOUSIN G & COM M DE V R M #111 1 181 9 FARNA M STREE T OMAHA.N E 6818 3 VENDOR : G WTIBB S CONSTRUCTIO N

ATT N GARR Y TIBB S 432 1 N 5 6 S T OMAHA . N E 6810 4 > BIL L TO : CIT Y O F OMAH A FINANC E DISBURSEMENT S ROO M #100 7 181 9 FARNA M STREE T OMAHA.N E 6818 3 • <

ORIGINA L PURCHAS E ORDE R - VENDOR' S COP Y (SE E rNSTRUCTION S BELOW ) CUSTOME R ACCOUN T NO . VENDO R NO . 8019 0 DAT E O F ORDER / BUYE R 25-JUL-0 8 P BURK E REVISE D DATE / /BUYE R 2WUL-0 8 P BURK E PAYMEN T TERM S SHI P VI A F.O.B . DESTINATIO N FREIGH T TERM S > - REQUESTOR/DELIVE R T O MARUC A T MARI E CONFIR M T O / TELEPHON E < ITE M PAR T NUMBE R / DESCRIPTIO N DELIVER Y DAT E QUANTIT Y UNI T UNI T PRIC E EXTENSIO N IMPORTAN T - D O NO T STAR T WOR K UNTI L PROCEE D ORDE ^ DEPARTMEN T - PE R GROUP : 2 0 BI D DATE D 7/16/08 . Al l price s an d amounts ; o n thi s orde r ar e expres s ! NEEDED : i 24-JUL-0 8 EP APAIN T STABILIZATIO N PROGRAM GROU P 2 0 111 3 WILLIAM ST . O SHI P TO : Addres s a t to p o f pag e I S ISSUE D B Y b d i n : U S TH E PLANNIN G Dol^a r 1,200.0 0 N

***** * * * *********** * ************************* *

SHI P TO : Addres s show n above . I f shipmen t i s delaye d o ran y item s no t available , advis e a t once . Pur chas e orde rnumbe rmus t appea ro n al l invoices ^ packages , packin g lists , bil l o f lading , an d correspondence . SHIPPIN G CHARGE S T O B E PREPAID . I F APPLICABL E AN D ADDE D T O INVOICED , cop y t o b e fur nishe d wit h invoice . TA X EXEMPTION : Th e Cit y o f Omah a i s exennp t from Federa l Excis e Taxe s an d th e Nebrask a an d Cit y o f Omah a Sale s Taxes . Federa l I.D . 476006304 ; STAT E I.D . 01-0316768 ; Fue l Dealer s Lie . 91-0316768 . Ci y Purchasin g Agen t / Buye r